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KAN EOZİNOFİL SEVİYELERİ İLE COVİD-19 MORTALİTESİ ARASINDAKİ İLİŞKİ

Yıl 2025, Cilt: 8 Sayı: 1, 11 - 25, 24.03.2025
https://doi.org/10.55517/mrr.1524149

Öz

Amaç: COVID-19, şiddetli akut solunum yolu sendromu SARS-COV-2’nin neden olduğu küresel bir pandemidir. Bu çalışmanın amacı, kan eozinofil düzeyleri ile COVID-19'un şiddeti ve mortalitesi arasındaki ilişkiyi belirlemektir. Yöntem: 678 hastanın verileri, Mart 2020 ile Aralık 2021 tarihleri arasında araştırmacılar tarafından bir hastanenin elektronik veri tabanından geriye dönük olarak toplandı. Bu tanımlayıcı bir çalışmadır ve özel bir örnekleme yöntemi kullanılmamıştır. Veriler, hastaların üç grubuna (orta, şiddetli ve kronik) dayanarak değerlendirildi. Hastaneye yatışı takip eden ilk 24 saat içinde alınan eozinofil değerleri elde edildi. Veriler, IBM SPSS Statistics (20.0) yazılımı kullanılarak analiz edildi. Normal dağılım varsayımlarının karşılandığı durumlarda parametrik testler kullanıldı. İki bağımsız grup için Mann-Whitney U testi ve ilişkileri belirlemek için çok değişkenli lojistik regresyon analizi kullanıldı. p değeri <0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Çalışmamızda eozinofil düzeylerinin hastalık şiddetinde etkili olmadığı bulunmuştur (p=0,941). COVID-19’a bağlı ölüm oranı %14,6, şiddetli/kritik hastalık seyri oranı ise %27,3 olarak bulunmuştur. Hematolojik parametreler incelendiğinde, kritik vakaların anlamlı derecede daha yüksek NEU değerlerine (p=0,001) ve PCT değerlerine (p=0,024) sahip olduğu gözlenmiştir. LYM (p=0,007), HGB (p=0,029), PLT (p=0,023), HCT (p=0,005), MCV (p=0,039), MCH (p=0,048), MCHC (p=0,001) ve RDW (p=0,023) parametreleri şiddetli grupta anlamlı derecede düşüktür. Yaş, HCT, MCV, MCHC, üre, ürik asit, sodyum ve potasyum parametrelerinin mortalite için anlamlı risk faktörleri olmadığı belirlenmştir (p>0,05). MCHC'de azalma (OR: 0,996; p=0,007) ve sodyumda azalma (p=0,031) hastalık şiddeti üzerinde hafifletici bir etki göstermiştir. Diğer parametrelerin etkisi istatistiksel olarak anlamlı bulunmamıştır. Sonuç: Eozinofil düzeyinin COVID-19'un şiddeti ve mortalitesi üzerine etkisi bulunmamış olup, MCHC'de azalma ve sodyumda azalma hastalık şiddeti üzerinde hafifletici bir etki göstermiştir. Bu göstergelerin COVID-19 hastalarındaki klinik önemini araştırmak için daha fazla araştırmaya ihtiyaç vardır.

Kaynakça

  • Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
  • Memikoğlu O, Genç V. COVİD-19. E-Kitap. Ankara: Ankara Üniversitesi Basımevi; 2020. ISBN: 978-605-136-477-3.
  • Luecke E, Jeron A, Kroeger A, Bruder D, Stegemann-Koniszewski S, Jechorek D, Borucki K, Reinhold D, Reinhold A, Foellner S, Walles T, Hachenberg T, Schreiber J. Eosinophilic pulmonary vasculitis as a manifestation of the hyperinflammatory phase of COVID-19. J Allergy Clin Immunol. 2021 Jan;147(1):112-113. doi: 10.1016/j.jaci.2020.09.026.
  • Xia Z. Eosinopenia as an early diagnostic marker of COVID-19 at the time of the epidemic. EClinicalMedicine. 2020 Jun; 23:100398. doi:10.1016/j.eclinm.2020.100398
  • Tanni F, Akker E, Zaman MM, Figueroa N, Tharian B, Hupart KH. Eosinopenia and COVID-19. J Am Osteopath Assoc. Published online July 16, 2020. doi:10.7556/jaoa.2020.091
  • Zhao L, Zhang YP, Yang X, Liu X. Eosinopenia is associated with greater severity in patients with coronavirus disease 2019. Allergy. 2021;76(2):562-564. doi:10.1111/all.14455
  • Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al.Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020 Jul;75(7):1730-1741. doi: 10.1111/all.14238.
  • Qian GQ, Yang NB, Ding F, Ma AHY, Wang ZY, Shen YF, et al. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series. QJM. 2020 Jul 1;113(7):474-481. doi: 10.1093/qjmed/hcaa089.
  • Zheng Y, Xu H, Yang M, Zeng Y, Chen H, Liu R, et al.Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu. J Clin Virol. 2020 Jun;127:104366. doi: 10.1016/j.jcv.2020.104366.
  • Xuan W, Jiang X, Huang L, Pan S, Chen C, Zhang X, Zhu H, Zhang S, Yu W, Peng Z, Su D. Predictive Value of Eosinophil Count on COVID-19 Disease Progression and Outcomes, a Retrospective Study of Leishenshan Hospital in Wuhan, China. J Intensive Care Med. 2022 Mar;37(3):359-365. doi: 10.1177/08850666211037326.
  • Bivona G, Agnello L, Ciaccio M. Biomarkers for prognosis and treatment response in COVID-19 patients. Ann Lab Med. 2021 Nov; 41(6):540-548.
  • Sartini S, Massobrio L, Cutuli O, Campodonico P, Bernini C, Sartini M, et al. Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(21):11534. https://doi.org/10.3390/ijerph182111534
  • Noor FM, Islam MM. Prevalence and associated risk factors of mortality among COVID-19 patients: a meta-analysis. J Community Health. 2020 Dec; 45(6):1270-82.
  • Karakoc ZC, Pinarbasi Simsek B, Asil R, Dodurgali R, Caliskaner F, Ozsari A, et al. First wave in COVID-19 pandemic: a single center experience. Klimik Derg. 2020 Dec; 33(3):223-9.
  • Khan MMA, Khan MN, Mustagir MG, Rana J, Islam MS, Kabir MI. Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis. J Glob Health. 2020 Dec;10(2):020503. doi: 10.7189/jogh.10.020503.
  • Livingston E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. JAMA. 2020 Mar; 323(14):1335.
  • Boe DM, Boule LA, Kovacs EJ. Innate immune responses in the ageing lung. Clin Exp Immunol. 2017 Jan; 187(1):16-25.
  • Yan B, Yang J, Xie Y, Tang X. Relationship between blood eosinophil levels and COVID-19 mortality. World Allergy Organ J. 2021 Mar; 14(3):100521.
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020 Aug; 71(15):762-8.
  • Li Q, Ding X, Xia G, Chen HG, Chen F, Geng Z, et al. Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: A retrospective case-control study. EClinicalMedicine. 2020 May 3;23:100375. doi: 10.1016/j.eclinm.2020.100375.
  • Gu J, Gong E, Zhang B, Zheng J, Gao Z, Zhong Y, et al. Multiple organ infection and the pathogenesis of SARS. J Exp Med. 2005 Aug; 202:415-24.
  • Velavan TP, Meyer CG. Mild versus severe COVID-19: laboratory markers. Int J Infect Dis. 2020 Jun; 95:304-7.
  • Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. J Allergy Clin Immunol. 2020 Jul; 146(1):1-7.
  • Huang J, Zhang Z, Liu S, Gong C, Chen L, Ai G, et al. Absolute eosinophil count predicts intensive care unit transfer among elderly COVID-19 patients from general isolation wards. Front Med. 2020 Nov; 11. doi:10.3389/fmed.2020.585222.
  • Chen F, Chen W, Chen J, Xu D, Xie W, Wang X, et al. Clinical features and risk factors of COVID-19-associated liver injury and function: A retrospective analysis of 830 cases. Ann Hepatol. 2021 Mar-Apr;21:100267. doi: 10.1016/j.aohep.2020.09.011.
  • Samidurai A, Das A. Cardiovascular complications associated with COVID-19 and potential therapeutic strategies. Int J Mol Sci. 2020 Sep; 21(18):6785.
  • Chidambaram V, Tun NL, Haque WZ, Majella MG, Sivakumar RK, Kumar A, et al. Factors associated with disease severity and mortality among patients with COVID-19: a systematic review and meta-analysis. PLoS One. 2020 Nov; 15(11):e0241541.
  • Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, et al.. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC Infect Dis. 2020 Jul 16;20(1):519. doi: 10.1186/s12879-020-05242-w.
  • Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020 May;97(5):829-838. doi: 10.1016/j.kint.2020.03.005.

The Relationship Between Blood Eosinophil Levels and COVID-19 Mortality

Yıl 2025, Cilt: 8 Sayı: 1, 11 - 25, 24.03.2025
https://doi.org/10.55517/mrr.1524149

Öz

Aim: COVID-19 is a global pandemic caused by severe acute respiratory syndrome (SARS-COV-2). The objective of this study is to determine the relationship between blood eosinophil levels and the severity and mortality of COVID-19. Methods: The data of 678 patients were retrospectively collected from the electronic database of a hospital by researchers between March 2020 and December 2021. This is a descriptive study, and no specific sampling method was employed. The data were evaluated based on three groups of patients (moderate, severe, and chronic). Eosinophil values within the first 24 hours following hospital admission were obtained. The data was analyzed through IBM SPSS Statistics (20.0) software. Parametric tests were used for the statistical evaluations when the normality assumptions were met. Mann-Whitney U was used for two independent groups and multivariate logistic regression analysis was used to identify the relations. p-value < 0.05 was considered statistically significant. Results: In our study, it was found that eosinophil levels did not have an effect on disease severity (p=0.941). The COVID-19 related mortality rate was 14.6%, and the rate of severe/critical disease progression was 27.3%. Upon examining hematological parameters, it was observed that critical cases had significantly higher NEU values (p=0.001) and PCT values (p=0.024). LYM (p=0.007), HGB (p=0.029), PLT (p=0.023), HCT (p=0.005), MCV (p=0.039), MCH (p=0.048), MCHC (p=0.001), and RDW (p=0.023) were significantly lower in the severe group. It was determined that age, HCT, MCV, MCHC, urea, uric acid, sodium and potassium parameters were not significant risk factors for mortality (p>0.05). A reduction in MCHC (OR: 0.996; p=0.007) and sodium (p=0.031) demonstrated a mitigating effect on disease severity. The predictive effect of other parameters was found to be statistically insignificant. Conclusion: The effect of eosinophil levels on the severity and mortality of COVID-19 has not been found, whereas a decrease in MCHC and sodium levels showed a mitigating effect on disease severity. Further research is needed to investigate the clinical significance of these indicators in COVID-19 patients.

Etik Beyan

This protocol was approved by the Ethics Committee of Katip Çelebi University Non-Interventional Clinic Studies (no. 54; date of approval: February 24, 2022) and was performed in accordance with the Declaration of Helsinki. Informed consent was not obtained as this is a retrospective study.

Kaynakça

  • Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.
  • Memikoğlu O, Genç V. COVİD-19. E-Kitap. Ankara: Ankara Üniversitesi Basımevi; 2020. ISBN: 978-605-136-477-3.
  • Luecke E, Jeron A, Kroeger A, Bruder D, Stegemann-Koniszewski S, Jechorek D, Borucki K, Reinhold D, Reinhold A, Foellner S, Walles T, Hachenberg T, Schreiber J. Eosinophilic pulmonary vasculitis as a manifestation of the hyperinflammatory phase of COVID-19. J Allergy Clin Immunol. 2021 Jan;147(1):112-113. doi: 10.1016/j.jaci.2020.09.026.
  • Xia Z. Eosinopenia as an early diagnostic marker of COVID-19 at the time of the epidemic. EClinicalMedicine. 2020 Jun; 23:100398. doi:10.1016/j.eclinm.2020.100398
  • Tanni F, Akker E, Zaman MM, Figueroa N, Tharian B, Hupart KH. Eosinopenia and COVID-19. J Am Osteopath Assoc. Published online July 16, 2020. doi:10.7556/jaoa.2020.091
  • Zhao L, Zhang YP, Yang X, Liu X. Eosinopenia is associated with greater severity in patients with coronavirus disease 2019. Allergy. 2021;76(2):562-564. doi:10.1111/all.14455
  • Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al.Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020 Jul;75(7):1730-1741. doi: 10.1111/all.14238.
  • Qian GQ, Yang NB, Ding F, Ma AHY, Wang ZY, Shen YF, et al. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series. QJM. 2020 Jul 1;113(7):474-481. doi: 10.1093/qjmed/hcaa089.
  • Zheng Y, Xu H, Yang M, Zeng Y, Chen H, Liu R, et al.Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu. J Clin Virol. 2020 Jun;127:104366. doi: 10.1016/j.jcv.2020.104366.
  • Xuan W, Jiang X, Huang L, Pan S, Chen C, Zhang X, Zhu H, Zhang S, Yu W, Peng Z, Su D. Predictive Value of Eosinophil Count on COVID-19 Disease Progression and Outcomes, a Retrospective Study of Leishenshan Hospital in Wuhan, China. J Intensive Care Med. 2022 Mar;37(3):359-365. doi: 10.1177/08850666211037326.
  • Bivona G, Agnello L, Ciaccio M. Biomarkers for prognosis and treatment response in COVID-19 patients. Ann Lab Med. 2021 Nov; 41(6):540-548.
  • Sartini S, Massobrio L, Cutuli O, Campodonico P, Bernini C, Sartini M, et al. Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(21):11534. https://doi.org/10.3390/ijerph182111534
  • Noor FM, Islam MM. Prevalence and associated risk factors of mortality among COVID-19 patients: a meta-analysis. J Community Health. 2020 Dec; 45(6):1270-82.
  • Karakoc ZC, Pinarbasi Simsek B, Asil R, Dodurgali R, Caliskaner F, Ozsari A, et al. First wave in COVID-19 pandemic: a single center experience. Klimik Derg. 2020 Dec; 33(3):223-9.
  • Khan MMA, Khan MN, Mustagir MG, Rana J, Islam MS, Kabir MI. Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: A systematic review and meta-analysis. J Glob Health. 2020 Dec;10(2):020503. doi: 10.7189/jogh.10.020503.
  • Livingston E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. JAMA. 2020 Mar; 323(14):1335.
  • Boe DM, Boule LA, Kovacs EJ. Innate immune responses in the ageing lung. Clin Exp Immunol. 2017 Jan; 187(1):16-25.
  • Yan B, Yang J, Xie Y, Tang X. Relationship between blood eosinophil levels and COVID-19 mortality. World Allergy Organ J. 2021 Mar; 14(3):100521.
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020 Aug; 71(15):762-8.
  • Li Q, Ding X, Xia G, Chen HG, Chen F, Geng Z, et al. Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: A retrospective case-control study. EClinicalMedicine. 2020 May 3;23:100375. doi: 10.1016/j.eclinm.2020.100375.
  • Gu J, Gong E, Zhang B, Zheng J, Gao Z, Zhong Y, et al. Multiple organ infection and the pathogenesis of SARS. J Exp Med. 2005 Aug; 202:415-24.
  • Velavan TP, Meyer CG. Mild versus severe COVID-19: laboratory markers. Int J Infect Dis. 2020 Jun; 95:304-7.
  • Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination. J Allergy Clin Immunol. 2020 Jul; 146(1):1-7.
  • Huang J, Zhang Z, Liu S, Gong C, Chen L, Ai G, et al. Absolute eosinophil count predicts intensive care unit transfer among elderly COVID-19 patients from general isolation wards. Front Med. 2020 Nov; 11. doi:10.3389/fmed.2020.585222.
  • Chen F, Chen W, Chen J, Xu D, Xie W, Wang X, et al. Clinical features and risk factors of COVID-19-associated liver injury and function: A retrospective analysis of 830 cases. Ann Hepatol. 2021 Mar-Apr;21:100267. doi: 10.1016/j.aohep.2020.09.011.
  • Samidurai A, Das A. Cardiovascular complications associated with COVID-19 and potential therapeutic strategies. Int J Mol Sci. 2020 Sep; 21(18):6785.
  • Chidambaram V, Tun NL, Haque WZ, Majella MG, Sivakumar RK, Kumar A, et al. Factors associated with disease severity and mortality among patients with COVID-19: a systematic review and meta-analysis. PLoS One. 2020 Nov; 15(11):e0241541.
  • Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, et al.. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC Infect Dis. 2020 Jul 16;20(1):519. doi: 10.1186/s12879-020-05242-w.
  • Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020 May;97(5):829-838. doi: 10.1016/j.kint.2020.03.005.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Bulaşıcı Hastalıklar, Göğüs Hastalıkları, İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Gökben Yaslı 0000-0003-2464-2238

Gülper Şener 0009-0007-0121-6005

Ebru Turhan 0000-0003-2387-3253

Yayımlanma Tarihi 24 Mart 2025
Gönderilme Tarihi 29 Temmuz 2024
Kabul Tarihi 24 Şubat 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 1

Kaynak Göster

Vancouver Yaslı G, Şener G, Turhan E. The Relationship Between Blood Eosinophil Levels and COVID-19 Mortality. MRR. 2025;8(1):11-25.